Table 2.

Items agreed to be essential (> 70% of participants said they were “essential”)

item			Round 1 %	Round 2 %	Round 3 %	AUS-NZ	UK
AUS-NZ: Australia and New Zealand, UK: the United Kingdom, *: Essential, NRC: did not reach consensus, NE: not essential, N/A: not available ECG: electrocardiogram, PiCCO: pulse contour cardiac output, CO: cardiac output, CI: cardiac index, SVV: stroke volume variation, SVRI: systemic vascular resistance index, PAP: pulmonary artery pressure, ECMO: extracorporeal membrane oxygenation, CPAP: continuous positive airway pressure, PEEP: positive end expiratory pressure, EPAP: expiratory positive airway pressure, PS: pressure support, IPAP: Inspiratory Positive Airway Pressure, SIMV: synchronised intermittent mandatory ventilation, STEMI: ST elevation myocardial infarction, NSTEMI: non-ST elevation myocardial infarction, VAP: ventilator-associated pneumonia, MODS: multiple organ dysfunction syndrome, COPD: chronic obstructive pulmonary disease, PVC: premature ventricular contraction, ALT: alanine aminotransferase, LDH: lactate dehydrogenase, FEV1: forced expiratory volume in one second, FVC: forced vital capacity, CAM-ICU: confusion assessment method for the intensive care unit, CT: computed tomography, MRI: magnetic resonance imaging, ASIA: American Spinal Cord Injury Association, HCO3: bicarbonate, PaCO2: partial pressure of arterial carbon dioxide, PaO2: partial pressure of arterial oxygen, SPO2: peripheral capillary oxygen saturation, SaO2: arterial oxygen saturation, pH: potential of hydrogen, SvO2: mixed venous oxygen saturation, FiO2: fraction of inspired oxygen ACBT: active cycle of breathing technique, FET: forced expiratory technique, MRC: Medical Research Council, 6MWT: 6-minute walk test, EQ-5D: EuroQol 5 Dimension, AQoL: Assessment of Quality of Life
A physiotherapist is aware or has knowledge of
	Key literature that guides evidence-based physiotherapy practice in critical care settings
		Key literature that guides evidence-based physiotherapy practice in critical care settings	100	―	―	*	NRC
	The actions and implications for physiotherapy of the following medications
		Analgesia	93	―	―	*	N/A
		Anti-arrhythmics (e.g. amiodarone, digoxin)	96	―	―	*	*
		Anti-hypertensives (e.g. beta-blockers, hydralazine)	98	―	―	*	*
		Bronchodilators	89	―	―	*	*
		Calcium channel blockers	87	―	―	NRC	NE
		Sedation and neuromuscular paralyzing agents	100	―	―	*	*
		Vasopressors/inotropes (e.g. dobutamine, milrinone, adrenaline, dopamine, noradrenaline)	100	―	―	*	*
	Methods for advanced hemodynamic monitoring, can interpret the measurements and understands the implications for physiotherapy of
		Implanted or external pacemakers, and determine the presence of pacing on ECG	96	―	―	*	NRC
		PiCCO measurements (e.g. CO, CI, SVV, SVRI etc.)	83	―	―	NE	NE
		Pulmonary arterial catheter measurements (e.g. CO, CI, SVRI, PAP, etc.)	85	―	―	NE	NE
A physiotherapist can understand
	Equipment (including recognition of equipment), can use/safely apply or handle equipment, understands the implications for physiotherapy of
		Arterial lines	100	―	―	*	*
		Central venous catheters	98	―	―	*	*
		ECMO	74	―	―	NE	NE
		Endotracheal tubes and tracheostomy	100	―	―	*	*
		Indwelling urinary catheters	91	―	―	*	*
		Intercostal catheters	100	―	―	*	*
		Intra-aortic balloon pump	89	―	―	NRC	NE
		Intracranial pressure (ICP) monitors and extra-ventricular drains (EVD)	91	―	―	*	NE
		Nasogastric tubes	98	―	―	*	*
		Oxygen therapy devices	100	―	―	*	*
		Vascath/hemodialysis/continuous veno-venous hemodiafiltration	94	―	―	*	*
		Wound drains	100	―	―	*	*
	The key principles of providing the following differing modes of mechanical/assisted ventilation including
		Airway Pressure Release Ventilation (APRV)	76	―	―	NE	NE
		Assist-control	98	―	―	*	NRC
		BiLevel	83	―	―	*	*
		CPAP	98	―	―	*	*
		PEEP/EPAP	100	―	―	*	*
		Pressure-regulated Volume Control (PRVC)	81	―	―	*	N/A
		PS/IPAP	100	―	―	*	*
		SIMV (Volume) / (Pressure)	93	―	―	*	*
		Weaning protocols	96	―	―	*	NRC
	Pathophysiology and presenting features, likely medical management and implications for physiotherapy for a range of conditions including
		Acute coronary syndrome (e.g. angina, STEMI, NSTEMI)	100	―	―	*	*
		Acute lung injury/acute respiratory distress syndrome (ARDS)	98	―	―	*	*
		Burns (cutaneous/inhalational)	81	―	―	NRC	NE
		Chest trauma	93	―	―	*	*
		Community acquired/nosocomial/hospital-acquired pneumonia (including VAP)	100	―	―	*	*
		Guillain-Barre Syndrome	76	―	―	*	*
		Heart failure	100	―	―	*	*
		Hepatitis	72	―	―	NRC	NE
		ICU-acquired weakness (ICU-AW)	100	―	―	*	*
		Immunocompromise	65	85	―	*	*
		Intracerebral hemorrhage/Subarachnoid hemorrhage	100	―	―	*	*
		Metabolic/electrolyte disturbances	98	―	―	*	NRC
		Multi-organ failure/MODS	94	―	―	*	*
		Multi-trauma	93	―	―	*	NRC
		Obstructive respiratory disease (e.g. asthma, COPD)	100	―	―	*	*
		Pancreatitis	76	―	―	*	NRC
		Pleural effusion	98	―	―	*	*
		Post-abdominal surgery	98	―	―	*	*
		Post-cardiac surgery	94	―	―	*	NRC
		Post-surgery other (e.g. orthopaedic, vascular)	94	―	―	*	N/A
		Post-thoracic surgery	100	―	―	*	NRC
		Renal failure (acute and chronic)	100	―	―	*	*
		Respiratory failure (Type I and II)	100	―	―	*	*
		Restrictive respiratory disease (e.g. pulmonary fibrosis, kyphoscoliosis)	98	―	―	*	*
		Shock (cardiogenic)	98	―	―	*	*
		Shock (septic)	94	―	―	*	*
		Spinal cord injury	96	―	―	*	*
		Suppurative lung disease (e.g. cystic fibrosis, bronchiectasis)	74	―	―	*	*
		Systemic inflammatory response syndrome (SIRS)	89	―	―	*	*
		Thromboembolic disease (e.g. deep vein thrombosis, pulmonary embolus)	100	―	―	*	*
		Thrombotic cerebrovascular accident	96	―	―	*	N/A
		Traumatic brain injury	94	―	―	*	*
A physiotherapist can accurately/independently (assess and) interpret
	Readings from clinical monitoring including
		Advanced ECGs (i.e. conduction block, 12-lead ECG)	80	―	―	NE	NRC
		Basic ECGs (i.e. sinus rhythm/tachycardia/bradycardia, atrial fibrillation, atrial flutter, ventricular tachycardia, ventricular fibrillation, asystole, PVCs)	98	―	―	*	*
		Blood pressure (systolic, diastolic, and mean arterial blood pressure)	100	―	―	*	*
		Body temperature	100	―	―	*	*
		Central venous pressure	94	―	―	*	NRC
		End tidal carbon dioxide	83	―	―	*	*
		Fluid intake and output	96	―	―	*	*
		Heart rate	100	―	―	*	*
		Nutritional status including feed administration, volume and type	85	―	―	NE	NE
		SpO2/Pulse oximetry	100	―	―	*	*
	Findings from laboratory investigations including
		Albumin	94	―	―	NE	NE
		Blood glucose levels	96	―	―	*	*
		C-reactive protein (CRP)	100	―	―	NRC	*
		Creatinine kinase (CK)	98	―	―	NRC	NE
		Hematocrit	83	―	―	NE	NE
		Hemoglobin	100	―	―	*	*
		Liver function tests (e.g. ALT, LDH, Bilirubin)	93	―	―	NE	NE
		Neutrophil counts	80	―	―	NRC	NE
		Platelets, APTT (activated partial thromboplastin time), INR (international normalized ratio)	87	―	―	*	*
		Renal function tests (e.g. urea, creatinine)	93	―	―	*	NRC
		Respiratory function tests (e.g. FEV1, FVC etc.)	98	―	―	*	NRC
		Troponin	76	―	―	*	*
		White cell count (WCC)	98	―	―	*	*
	Findings from imaging investigations (excluding the imaging report) including
		Chest radiographs (CXR)	94	―	―	*	*
		CT - Brain imaging	74	―	―	NE	NE
		CT - Chest imaging	81	―	―	NE	NE
		MRI - Brain	74	―	―	NE	NE
		Skeletal X-rays	81	―	―	NRC	NE
		Ultrasound - Chest	74	―	―	NE	NE
	Results from neurological equipment/examinations and functional tests including
		Ability to interpret a delirium assessment (e.g. the CAM-ICU)	96	―	―	NRC	N/A
		Ability to perform a delirium assessment (e.g. the CAM-ICU)	83	―	―	NE	NE
		An ability to interpret a Glasgow Coma Score (GCS)	100	―	―	*	*
		An ability to interpret an assessment of cranial nerve function	93	―	―	NRC	NE
		An ability to interpret an assessment of sedation levels (e.g. Ramsey Sedation Scale, Richmond Agitation-Sedation Scale)	100	―	―	*	NRC
		An ability to perform a Glasgow Coma Score (GCS)	93	―	―	NRC	NE
		An ability to perform a neurological examination of motor and sensory functions (e.g. light touch, pain, ASIA score)	98	―	―	*	NRC
		An ability to perform an assessment of cranial nerve function	93	―	―	NE	NE
		An ability to perform an assessment of sedation levels	98	―	―	NE	NE
		Intra-cranial pressure (ICP) monitors (intra-parenchymal, intra-ventricular) and cerebral perfusion pressure (CPP)	52	74	―	*	NRC
	Indices from blood gas measurement including
		A-a gradient	81	―	―	NE	NE
		Base excess	76	―	―	*	*
		HCO3	91	―	―	*	*
		Lactate	87	―	―	NE	NRC
		PaCO2	100	―	―	*	*
		PaO2, SpO2, SaO2	100	―	―	*	*
		PaO2/FiO2 ratio	100	―	―	*	NE
		pH	98	―	―	*	*
		Venous blood gas interpretation (including SvO2)	74	―	―	NRC	NE
	(assess and interpret) Mechanical ventilation settings/measurements including
		Breath types (spontaneous, mandatory, assisted)	100	―	―	*	*
		Maximum inspiratory pressure (MIP) measurements	63	72	―	NE	NE
		Peak inspiratory pressure	93	―	―	*	*
		Respiratory rate	100	―	―	*	*
		Static and/or dynamic lung compliance measures	61	72	―	NE	NE
		The level of FiO2	100	―	―	*	*
		The level of PEEP	100	―	―	*	*
		The level of PS	98	―	―	*	*
		Tidal volume	100	―	―	*	*
A physiotherapist can
	Perform and accurately interpret the results of common respiratory examinations including
		Auscultation	100	―	―	*	*
		Observation of respiratory rate	100	―	―	*	*
		Palpate the chest wall	94	―	―	*	*
		Patterns of breathing	100	―	―	*	*
	Assess
		The effectiveness/quality of a patient's cough (on or off mechanical ventilation)	96	―	―	*	*
	Provide the following techniques, including an understanding of indications, contraindications, evidence for the technique, and progressions
		ACBT [breathing control, thoracic expansion and FET]	83			*	*
		Assisted coughing - chest wall	85	―	―	*	*
		Assisted coughing - subcostal thrusts for spinal cord injuries	54	74	―	*	NRC
		Bed exercises (e.g. passive - active - resisted range of motion exercises)	100	―	―	*	*
		Braces	74	―	―	NE	NE
		Directed coughing/instructing the patient to cough effectively	96	―	―	*	*
		Electrical stimulation (e.g. for isolated muscle activation to prevent muscle wasting, such as neuromuscular/functional electrical stimulation)	78	―	―	NE	NE
		Humidification	76	―	―	*	*
		Inexsufflator (Cough Assist)	65	70	―	NE	*
		Inspiratory muscle training	78	―	―	NE	NE
		Mobilization of non-ventilated patient (e.g. sitting on edge of bed, stand, hoist or slide transfer to chair, march on spot, walk, use of gait aids)	100	―	―	*	*
		Mobilization of ventilated patient (e.g. sitting on edge of bed, stand, hoist or slide transfer to chair, march on spot, walk, use of gait aids)	98	―	―	*	*
		NIV/BiPAP - for use during exercise or mobilization including initiation and titration of	69	70	―	NRC	NE
		Patient positioning for prevention of pressure ulcers, management of tone, maintenance of musculoskeletal function	100	―	―	*	*
		Patient positioning for respiratory care - including use of side lie, sitting upright, postural drainage (modified or head down tilt)	100	―	―	*	*
		Patient prone positioning in severe respiratory failure/acute lung injury	87	―	―	NRC	NRC
		Pursed lip breathing	98	―	―	*	N/A
		Suction via a tracheal tube (Endotracheal tube, tracheostomy, minitracheostomy)	67	72	―	*	*
		Supported coughing	98	―	―	*	*
		Treadmill, cycle ergometry (e.g. Motomed) or stationary bike	87	―	―	NRC	NE
A physiotherapist can
	Complete musculoskeletal and/or functional assessments including
		Ability to assess tone (e.g. utilizing a Modified Ashworth Scale) and reflexes	100	―	―	*	NRC
		Deep vein thrombosis screening (i.e. color, temperature, touch, swelling, Homan's test)	93	―	―	*	*
		Dynamometry	81	―	―	NRC	NE
		Manual muscle testing (e.g. MRC scale)	98	―	―	*	*
		Objective measures of cardiopulmonary exercise tolerance (e.g. 6-minute walk test; incremental shuttle walk test)	87	―	―	NRC	NE
		Objective measures of physical function [e.g. the Physical Function ICU Test (PFIT), Timed Up and Go Test (TUG), 6MWT, De-Morton Mobility Index (DEMMI) ]	93	―	―	*	NE
		Objective measures of quality of life (e.g. Short Form 36, EQ-5D, AQoL)	72	―	―	NE	NE
		Peripheral edema	96	―	―	*	*
		Range of motion	100	―	―	*	*
	Appropriately
		Be aware of inotropes and implications for physiotherapy treatment	100	―	―	*	N/A
		Be aware of sedation and implications for physiotherapy treatment	98	―	―	*	N/A
		Liaise with medical/nursing staff to increase/decrease inotropes to achieve physiotherapy goals	85	―	―	*	N/A
		Liaise with medical/nursing staff to increase/decrease sedation to achieve physiotherapy goals	94	―	―	*	N/A
A physiotherapist can
		Assess and interpret ventilator waveforms	89	―	―	NE	N/A
		Determine the appropriateness of a patient for extubation	83	―	―	NRC	NRC